text: On the federal level, legislation regarding pharmacists' provider status was first introduced to the U.S. House of Representatives in 2014 by Representative Brett Guthrie (R-KY) in the 113th Congress. The purpose of the Pharmacy and Medically Underserved Areas Enhancement Act (HR 592) was to amend the Social Security Act to recognize pharmacists as healthcare providers and cover their services in medically underserved communities under Medicare Part B. This bill failed to pass and was reintroduced in 2015 by Representatives Brett Guthrie (R-KY), G.K. Butterfield (D-NC), and Todd Young (R-IN). Unfortunately, this bill expired once more at the end of the 114th Congress. It was reintroduced for the third time on Jan 12, 2017 during the 115th Congress by Representatives Sherrod Brown (D-OH), Bob Casey (D-PA), and Chuck Grassley (R-IA). The bill was referred to the Committee on Finance but was not enacted.
  A number of states are expanding the pharmacist's scope of practice through the implementation of advanced practice pharmacy.  In addition to the advanced practice designation, pharmacists in certain practice settings have been granted the ability to perform certain tasks under a collaborative practice agreement (CPA) with a physician. These tasks include the following:
  * Assess the patient by gathering subjective and objective information
  * Prescribe medications to manage disease states (starting, stopping, or adjusting treatment)
  * Order lab tests and interpret the results
  * Coordinate patient care with other healthcare professionals
  * Develop relationships with patient to allow for ongoing care
  Under this movement for expansion of pharmacists' scope of practice, the state of California instated Senate Bill 493 in 2014, written by Senator Ed Hernandez, authorizing pharmacists to furnish self-administered hormonal contraceptives, nicotine replacement products, and prescription medications recommended for international travelers not requiring a diagnosis, among other functions. The bill also authorized California-licensed pharmacists to order tests pertaining to the efficacy and safety of patient drug therapies as well as performing patient assessments. This bill was followed by Assembly Bill 1535 in 2014, granting California pharmacists the authority to furnish naloxone. As an adjunct to SB493 and AB1535, Assembly Bill 1114 was approved in California in 2016 to establish a fee schedule for pharmacist services under the Medi-Cal program, allowing for proper reimbursement of the following provided or furnished services:
  * Furnishing naloxone hydrochloride for opioid overdose
  * Initiating and administering immunizations
  * Furnishing self-administered hormonal contraception
  * Providing tobacco cessation counseling and furnishing nicotine replacement therapy
  * Furnishing travel medications to individuals not requiring a diagnosis
  In 2019, the California Department of Health Care Services (DHCS) established the fee schedule for AB1114, issuing the billing codes needed to implement the pharmacy services outlined by the bill.  Under AB 1114, pharmacists may bill for services using CPT code 99201 for new patients, CPT code 99212 for established patients, or CPT code 90471 for immunization administration.